Get the free Backflow Test Results Form

City of McKinneyPERMIT NUMBERBACKFLOW PREVENTION ASSEMBLY TEST & MAINTENANCE REPORT P.O.BOX 517 McKinney, TEXAS 75070This form MUST be COMPLETED for each assembly tested. A SIGNED and DATED ORIGINAL

How to fill out backflow test results form

How to fill out backflow test results form

1. To fill out a backflow test results form, follow these steps:
2. Start by providing the necessary information at the top of the form, such as the date, location, and testing company.
3. Fill in the customer information section, including the name, address, and contact details of the property owner or occupant.
4. Specify the type of backflow preventer being tested, such as a reduced pressure zone (RPZ) device or double check valve assembly (DCVA).
5. Record the backflow preventer's make, model, and serial number, usually found on a metal plate attached to the device.
6. Conduct the actual test by checking the system's water pressures, flow rates, and performing various test procedures as required by local regulations.
7. Evaluate the results of the test and carefully document any observed issues or failures. This may include identifying leaks, pressure drops, or excessive backflow.
8. If the backflow preventer passes the test, indicate that it is in compliance with regulations and note the appropriate test values.
9. If any discrepancies or failures are found, explain the issues in detail and recommend necessary repairs or adjustments to ensure compliance.
10. Once the form is completed, obtain the required signatures from the testing technician and the property owner or authorized representative.
11. Submit the filled-out form to the appropriate authorities, such as the local water department, health department, or plumbing agency, as required.

Who needs backflow test results form?

1. Anyone involved in backflow prevention and plumbing systems may need a backflow test results form.
2. This includes plumbing contractors, testing companies, property owners, property managers, and regulatory agencies.
3. Local water departments, health departments, or plumbing agencies often require these forms to ensure compliance with backflow prevention regulations.
4. Additionally, property owners or managers may need the test results form to keep records of their plumbing system's performance and maintenance.

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What is backflow test results form?

Backflow test results form is a document used to record the results of testing for backflow prevention devices.

Who is required to file backflow test results form?

Property owners or managers who have backflow prevention devices installed on their property are required to file backflow test results form.

How to fill out backflow test results form?

Backflow test results form should be filled out by a certified tester who has conducted the testing for backflow prevention devices. The form typically requires information such as the location of the device, the results of the test, and the signature of the tester.

What is the purpose of backflow test results form?

The purpose of backflow test results form is to ensure that backflow prevention devices are functioning properly and are in compliance with regulations to protect the public water supply.

What information must be reported on backflow test results form?

Information such as the location of the device, the test results, the date of testing, and the signature of the tester must be reported on backflow test results form.